Referral Rewards Check Request Tuscumbia Date* Sales Consultant Name* First Last Sales Consultant’s Sales Number*Sales Consultant Email* Social Security Number (Needed for 1099)*Make Check Payable To* First Last Is the Payee an Employee?* Yes No Amount of Reward (if known)Payee Address* Street Address Address Line 2 City AlabamaAlaskaAmerican SamoaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaGuamHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaNorthern Mariana IslandsOhioOklahomaOregonPennsylvaniaPuerto RicoRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahU.S. Virgin IslandsVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific State ZIP Code How is the Check to be Delivered?* Mail to Customer Give Check to Sales Consultant Stock Number Sold*New Customer’s Name* First Last Special Notes or InstructionsBy adding your initials in the box below, you agree that the referred customer above has never purchased a vehicle from Long-Lewis. They are a true first time buyer, and qualify for the Referral Rewards Program per company policy.*I understand that all referrals will be audited. If the customer listed above is not a first time buyer, the request will not be approved.*
